CLINICS

Clinics (Sao Paulo). 2017 October; 72(10): 642-644.
doi:10.6061/clinics/2017(10)09

Copyright © 2017 CLINICS

Plasmid-mediated mcr-1 in carbapenem-susceptible Escherichia coli ST156 causing a blood infection: an unnoticeable spread of colistin resistance in Brazil?

Flavia Rossi I * , Raquel Girardello I , Carlos Morais II III , Ana Paula Cury I , Layla Farage Martins II , Aline Maria da Silva II , Edson Abdala IV , João Carlos Setubal II III , Alberto José da Silva Duarte I

Divisao Laboratorio Central – LIM03, Setor de Microbiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR

Departamento de Bioquímica, Instituto de Química, Universidade de Sao Paulo, Sao Paulo, SP, BR

Nucleo de Apoio a Pesquisa em Biologia Computacional e Genomica (NUBIC), Universidade de Sao Paulo, Sao Paulo, SP, BR

Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR

*Corresponding author. E-mail: flaviarossi61@gmail.com

received March 7, 2017; revised May 23, 2017; accepted May 30, 2017.

Abstract

OBJECTIVE:

We describe an IncX4 pHC891/16mcr plasmid carrying mcr-1 in a colistin-resistant and carbapenem-susceptible E. coli isolate (HC891/16), ST156, which caused a blood infection in a Brazilian patient with gallbladder adenocarcinoma.

METHODS:

Strain HC891/16 was subjected to whole genome sequencing using the MiSeq Platform (Illumina, Inc., USA). Assembly was performed using Mira and ABACAS.

RESULTS:

The isolates showed resistance only to ciprofloxacin, ampicillin and cefoxitin, and whole-genome sequencing revealed the presence of aac(6′)Ib-cr and blaTEM1.

CONCLUSION:

Our findings warn of the possible silent dissemination of colistin resistance by carbapenem-susceptible mcr-1 producers, as colistin susceptibility is commonly tested only among carbapenem-resistant isolates.

Keywords: Colistin Resistance, Polymyxin Resistance, Escherichia Coli, Carbapenem-Susceptible, ST156


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